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 ISSI.
 
 
 At the late banquet of the Alumni Association of Rush Medi- 
 cal College, it was expected that Dr. Allport would respond to 
 the sentiment, " Dentistry and Dental Education, its Past, 
 Present and Future as related to Medicine." The speakers on 
 this occasion were however restricted in time to five minutes, and 
 thus he was only able to give a brief synopsis of what he had in- 
 tended to say, reserving his address in full for the transactions of the 
 Association. We however anticipate this publication by present- 
 ing his address to our readers, in the present issue of the Jour- 
 nal AND Examiner. That those who practice in the depart- 
 ment of dentistry known as dental surgery, or the treatment of 
 the natural teeth and their surroundings, should be medically 
 educated and therefore regarded as special practitioners in medi- 
 cine, can hardly be questioned. But that dental practitioners 
 not medically educated should be admitted as medical practition- 
 ers, is scarcely debatable. The only door to the medical profes- 
 sion is through regularly constituted medical colleges ; and we 
 would suggest to our dental friends that the means for acquiring 
 the highest scientific knowledge of their calling, should be found 
 in these institutions. But it should be remembered that a full 
 medical education has not been required or demanded of those 
 about entering upon dental practice. 
 
 The suggestion that medical graduates should be better in- 
 formed regarding this subject is worthy of consideration, and we 
 do not see how the position taken by the doctor can be well con- 
 troverted, for it is a fact, as said by the physician to whom he 
 refers, that medical men " do not know much about the teeth." 
 When a full medical education is demanded of those entering 
 upon the practice of dental and oral surgery (and the sooner 
 it is demanded the better) we have no doubt that medical colleges 
 will prepare themselves to meet the demand, and instruct not 
 only as to the diseases incident to that portion of the body and 
 the science of their treatment, but provide such clinical teaching 
 as will best qualify the student to put his knowledge into practice.
 
 The suggestion made that medically educated men who practice 
 dental and oral surgery should be received in the American 
 Medical Association on an equal footing with the practitioners in 
 any other department of medicine and have assigned to them a 
 section on dental and oral surgery, claims attention. When the 
 demand is made we do not see why it should not meet with a 
 respojse. This ;!epartment of practice should advanc. so as to 
 stand among the important specialties of medicine. — Editorial 
 from the Chicago Medical Journal and Examiner, April, 1881.
 
 RESPONSE TO THE TOAST, 
 
 DENTISTRY AND DENTAL EDUCATION 
 
 ITS PAST, PRESENT AND FUTURE, AS RELATED 
 TO MEDICINE. 
 
 I hardly know how to respond to the sentiment just read. 
 " Dentistry and Dental Education — its Past, Present and Fu- 
 ture, as related to medicine," contains, as the lawyers would 
 say, several "distinct counts," either of which gives rise to more 
 thought than can well be expressed in the time it would be proper 
 for me to occupy on the present occasion. Contrary to the pop- 
 ular notion, dentistry is not entirely of modern origin. Its his- 
 tory dates far back into the centuries. 
 
 To respond fully, therefore, to the sentiment proposed, I 
 should be obliged to trace carefully and consecutively ttyhis-^ CJ 
 try, both ancient and modern, and assume to be a prophet and 
 foretell its future. 
 
 With facts at hand and time to do it, it is not a difficult task 
 to write history ; but it is always a risky business to venture 
 upon prophecy. 
 
 As we are far more interested in the present and future of 
 dentistry than in the far-off past, I shall be pardoned, I trust, 
 Mr. President, if I but briefly allude to its early history, and 
 confine what I may say to more modern times ; and instead of 
 predicting the future of dentistry, I will state what I think it 
 ought to be, trusting that what should be will be. 
 
 Of the early history of dentistry we know but little. That it 
 was practiced at a very early period is fully proven by the facts 
 that teeth well-preserved from gold fillings have been found in 
 the mouths of mummies, and also that artificial teeth, mounted
 
 upon gold plates have been discovered in the monuments of the 
 Egyptians. 
 
 We are told that the ancients practiced it as a specialty in 
 medicine. But if so, its practice — like that of surgery — seems 
 to have fallen into the hands of mechanics at a later period. 
 
 During the latter part of what is known as the middle ages in 
 Europe, surgery, as you are aware, was practiced by barbers, by 
 the advice and under the direction of physicians ; and it will 
 hardly do to suppose that at this time dentistry was of higher 
 rank than surgery. 
 
 Soon after this, or cotemporary with the period mentioned by 
 medical writers as the revival of surgery, the first steps were 
 taken toward modern dental surgery ; and associated with the 
 dental literature of those times stand the names of Eustachius, 
 Fallopius and Pare, known to have been among the first, if they 
 were not the very first, surgeons and writers of their times. In fact, 
 it is owing to these great men of that day that surgery, whether 
 general or special, was first placed upon a scientific and reliable 
 foundation of dissection. Later, other medical men wrote more 
 or less upon the anatomy, diseases and treatment of the teeth. 
 Prominent among these was John Hunter, up to whose time 
 England or the world had not produced so great a surgeon. I 
 mention these things to remind you that the writings upon the 
 teeth up to about the last of the eighteenth and first of the nine- 
 teenth centuries were by anatomists and surgeons, and, 1 will 
 add, that they treated more of the structure, functions and dis- 
 eases of the teeth than in giving any practical direction as to 
 their treatment when diseased. 
 
 As the structure and functions of the teeth became better un- 
 derstood, and their importance to a healthy condition of the 
 body more fully realized, medical men began to appreciate the 
 importance of their preservation. But class influence, which has 
 always ruled so strongly in European countries, and placed the 
 ban of social ostracism upon all who engage in hand labor, may 
 be assigned as one reason why practical dentistry did not receive 
 its first great impulse from those who did so much to enlighten 
 the medical profession as to the structure of the teeth and their 
 diseases.
 
 Dental operations at that time, whatever they may have been 
 — like the Tude surgery of a century or two before — seem to 
 have been practiced as an art ; the latter by barbers, and the 
 former by jewelers and smiths. Dentistry in those days con- 
 sisted very largely of making artificial teeth. 
 
 During the latter part of the eighteenth century, the art began 
 to be practiced in America. As it proved to be remunerative 
 for the services rendered, and as muscle and brain enter into a 
 more equal contest for respectability in America than in Europe, 
 our country became the most fruitful field for the development of 
 practical dental science. Americans, always quick of percep- 
 tion, soon discovered that diseases of the teeth could not be in- 
 telligently and successfully treated without a knowledge of their 
 anatomical structure, as well as of their surroundings ; and, like 
 the barber-surgeons of whom I have spoken, they began to study 
 anatomy. Some even ventured so far upon the domain of medi- 
 cine as to acquire a limited knowledge of physiology and pathol- 
 ogy, and, with the purchase of a few secret prescriptions, they 
 assumed to be and the people dubbed them as " doctors." As the 
 need for a more scientific education became apparent, medical 
 men began to engage in the practice of dentistry, both as oper- 
 ators upon the natm'al teeth and as makers of artificial teeth. 
 From this point, especially in our own country, the science and 
 practice of dentistry rapidly developed. Dental magazines and 
 text-books were published, dental associations and colleges were 
 established, and soon the superior skill of American dentists 
 became so generally acknowledged that their services were in 
 demand in nearly all the countries of Europe. 
 
 When dental colleges were first established, dentistry consisted 
 mainly in the cleaning and extraction of the natural teeth, in 
 the treatment of inflamed or diseased gums and in filling what 
 would now be regarded as the simpler forms of cavities ; also in 
 mounting artificial teeth upon gold and silver plates, in the set- 
 ting of pivot teeth and in regulating the simpler cases of mal- 
 arranged teeth. At that period, extraction was the approved 
 treatment for teeth with exposed or aching pulps, abscess of roots 
 or absorbed sockets. Now, not only teeth with exposed but dead 
 pulps, abscess of roots, atrophied surroundings and necrosed jawS
 
 are regularly and successfully treated and saved. In no corre- 
 sponding period of time have the improvements in surgery been 
 so great as during the present century, and in no department of 
 conservative surgery have they been so emphasized as in the 
 treatment of diseases of the teeth and mouth ; and to my calling 
 must the credit of this improvement be mainly given. Noiv to 
 adopt extraction as the rule of practice in such cases would be 
 considered mal-practice. 
 
 Artificial teeth are now mounted not only upon gold and sil- 
 ver plates but upon at least ten diflFerent bases, of various degrees 
 of applicability and usefulness in the cases requiring substitutes 
 — each requiring an entirely different manipulation and mode of 
 treatment. In order to bestow the greatest benefits of the art, a 
 thorough knowledge of making and applying these various kinds 
 of work is absolutely essential. 
 
 In addition to the great improvements in the setting of artifi- 
 cial teeth, as a branch of mechanical dentistry, artificial fixtures 
 are now so constructed as to be far more generally useful in the 
 treatment of cleft palate than is the surgeon's knife. These im- 
 provements are but indications of the advance in all directions in 
 practice. 
 
 In the earlier days of our dental schools, so little was em- 
 braced within the practice of dentistry that a two-years' course 
 of college instruction seemed sufficient to qualify students to 
 practice in the two departments at the standard then main- 
 tained. But with the improvements and expansion thus far 
 made, it is no longer possible. There is enough now em- 
 braced in either department to engage the entire time and 
 talent of any one individual, and the greatest excellence can 
 only be secured by a division of practice. Those whose tastes 
 and talents best fit them for mechanical dentistry should pursue 
 that as a branch of art, and give it their exclusive attention ; and 
 those who practice dental and oral surgery should pursue it as a 
 branch of medicine, and educate themselves accordingly. To 
 this division of practice the objection is urged that the two de- 
 partments " lock and inter-lock " so intimately that the separa- 
 tion is not practicable. No doubt patients would find it more con- 
 venient to receive the mechanical and medical treatment from
 
 the same person. So, too, it would be more convenient for the 
 afflicted to have their limbs amputated and artificial ones sup- 
 plied by the same practitioner ; or to have the otologist treat the 
 ear and furnish ear-trumpets of his own manufacture. But ex- 
 perience has proven that patients are best served by receiving 
 medical treatment from medical men, and manufactured articles 
 from mechanical artists. 
 
 The same principle holds good, and must hold good, in the 
 two departments of dentistry. 
 
 An accomplished mechanical dentist must now not only under- 
 stand the nature and manner of manipulating the various mate- 
 rials I have mentioned into plates for artificial teeth, but he must 
 be so skilled as a mechanic that he will be able to adapt these 
 materials to the requirements of the case in hand in such a way 
 that patients will derive the greatest benefit possible from artifi- 
 cial teeth as masticators. He should be so versed in art that he 
 can adapt them to the face of the patient — in size, shape, color 
 and position in the mouth — so perfectly as to conceal the fact 
 that they are not natural ; and so fully should he understand the 
 essentials to correct and easy enunciation that they will act 
 as aids instead of impediments to speech, as is now too frequently 
 the case. 
 
 The apprenticeship to an ordinary trade is not less than three 
 years, and it can hardly be claimed that less time should be de- 
 voted to acquiring this most difficult art than is spent in learning 
 to be a blacksmith or a carpenter. Whoever pursues the calling 
 properly will have no time for the practice of medicine in any of 
 its branches. 
 
 About the same degree of anatomical knowledge should be re- 
 quired of the mechanical dentist that is expected of the painter, 
 sculptor or maker of artificial limbs, and more than this is 
 scarcely necessary. 
 
 I have now, as concisely as possible, given you a general idea 
 of the history and present status of dentistry ; and I wish to say, 
 in as emphatic a manner as I can, that it is to our dental colleges, 
 and to the arduous and self-denying labors of the teachers in those 
 schools, more than to any other cause, that dentistry owes its 
 present honorable position in the community and itts standing
 
 8 
 
 among the sciences. Each succeeding year the teachings in our 
 dental colleges are becoming more scientific, reaching farther 
 into the realm of medicine ; and still they claim to cover but a 
 portion of the science in their teaching. In proportion as stu- 
 dents are inclined to the study of medicine are they disinclined 
 to practice in mechanical dentistry. Not only is it becoming 
 distasteful to this class of practitioners, but they are dissatisfied 
 with confining their operations exclusive!}' to the^ teeth. Grad- 
 ually but surely are the best medically educated dentists reach- 
 ing for and bringing within the scope of their practice all opera- 
 tions and treatment not only of the teeth but of the jaws and 
 oral cavity, and owing to their great familiarity with the dis- 
 eases of the mouth and their habitual use of the delicate instru- 
 ments required, it is fitting that medically-educated specialists in 
 dental and oral surgery should control this department of prac- 
 tice. The ease and accuracy they acquire in operating about 
 these parts could not be possessed by the general' sU-rgeon. 
 
 Any treatment for arresting disease is legitimately a branch 
 of medicine, no matter whether it be pills, powders, the sur- 
 geon's knife, the cautery or materials for filling teeth. All are 
 equally therapeutical agents. But their intelligent use must be 
 based upon a knowledge of anatomy, physiology, pathology, 
 chemistry and therapeutics; for the human • organism is so inti- 
 mately related that each part, either directly^ or indirectly, 
 affects every other part. The same hearts blood sends its arte- 
 rial currents to every point ; the same nerve centers radiate their 
 impressions throughout the system, and the same vital force per- 
 vades every atom of its structure. This specialism, therefore, 
 cannot be legitimate unless its practice is laid in the fundamental 
 principles of medicine. 
 
 Appreciating this fact, there is a growing tendency among the 
 best dental graduates to make the diseases of the teeth and 
 mouth a specialty in medical practice; and that- they may be better 
 qualified to do this, many of them supplement their dental edu- 
 cation with a full course of instruction at our medical colleges. 
 
 Much of this time could be saved if these colleges provided 
 ample instruction in dental and oral surgery, and exacted of
 
 their graduates a knowledge of the pathology of the diseases \n 
 this specialty and the science of their treatment. 
 
 Dental text-books devoted to diseases and treatment of the 
 teeth are seldom found in medical libraries, and medical text- 
 books, as well as lectures in medical colleges, have hitherto been 
 comparatively silent upon this subject ; which fact has necessi- 
 tated the organization and maintainance of dental colleges — 
 until it is claimed by some that dentistry has almost created for 
 itself a separate science. But since the teeth constitute a por- 
 tion of the human body, there can be no separate science for 
 the treatment of their disease. 
 
 All change from rest to unrest in any organ of the body is a 
 change from health to disease, and its pathology and treatment 
 should be taught in medical text-books and colleges. Without 
 it they are but partial teachers of the curative art, and fall, 
 therefore, short of accomplishing their whole mission. As med- 
 ical colleges are now constituted, medical graduates go forth in 
 as great or greater ignorance of diseases of the teeth than do 
 dental graduates of general disease. As an illustration of this 
 lack of knowledge on the part of physicians, 1 will give a single 
 instance, which is a fair sample of others constantly occurring, 
 and which could be given by almost any dental practitioner. 
 
 A physician of large and respectable practice came to me a 
 few months ago with a patient having a swollen face. Said he, 
 " Doctor, this patient has been suffering for several days with 
 toothache, and as nothing I can do affords relief I have brought 
 her to you to have the nerve killed." I replied : 
 
 " Yes, Doctor, I see it is an ulcerated tooth. The nerve has 
 undoubtedly been dead for a long time." 
 
 On raising the upper lip, I called his attention to an abscess 
 just ready to burst, over the root of a cuspid tooth. I took my 
 bistoury and, with a slight puncture, brought the pus. Said he, 
 " Doctor, are you sure the nerve in that tooth is dead ? " I re- 
 plied that an abscess over the root of a tooth was one of the 
 surest indications of the death of the pulp, and passed an instru- 
 ment the entire length of the nerve canal, to convince him that 
 the pulp was dead, He looked thoughtful for a moment, and
 
 10 
 
 said, " I don't think physicians know much about diseases of the 
 teeth." I told him I thought lie was nearer right in that re- 
 mark than in his diagnosis of this case. 
 
 Now, this physician was not only a professor in a medical col- 
 lege but he was the occupaat of a chair, which made it reason- 
 able to suppose that he would know the diiference between pulp- 
 itis and alveolar abscess. Had he but listened to a few lectures 
 on dental pathology, in his student days, he would hardly have 
 made this humiliating mistake. 
 
 Medical colleges do not educate specialists ; they but lay the 
 foundation for general practice. This knowledge acquired, the 
 practitioner may turn his attention to general practice or the 
 specialty of his choice ; and by the application of the principles 
 first taught, he is supposed to become more than ordinarily 
 skilled in the treatment of the particular class of diseases in his 
 specialty. 
 
 With this idea in view, there is no more reason why we should 
 have colleges for the teaching of the science involved in dental 
 or oral surgery, independently of general medicine, than for gen- 
 eral surgery. 
 
 One of the first requisites to success in the practice of any de- 
 partment of surgery or dentistry, is mechanical and executive 
 talent. Without these a physician may be able to diagnosticate 
 accurately and prescribe scientifically, but he can never succeed 
 as an operator, either in dental or general surgery. But if he is 
 educated in either of these specialties, without a general medical 
 education, he is left no choice save to follow that branch for 
 which he is educated, though he finds by experience that he has 
 not the requisite talent to succeed in its practice. Many gradu- 
 ates of our dental colleges find themselves in this ver}'' unpleas- 
 ant position. The result is, we have too many engaged in dental 
 practice Avho, neither by taste nor talent, are fitted for it ; and, 
 lacking a medical education, they cannot engage in general prac- 
 tice. Properly educated, many of them would make excellent 
 practitioners in medicine, but they are failures as dentists, as 
 they would have been as surgeons. 
 
 The change advocated would give the student a chance for 
 the exercise of his choice, ennabling him, after his regular
 
 11 
 
 college course, to select the special branch for which he feels 
 himself to be best adapted. If he chooses the specialty of dental 
 and oral surgery, rather than to engage in the general practice 
 of medicine, the teaching he has received should be supple- 
 mented by such clinical and other instruction as will best qualify 
 him to engage in that department of practice. A medical edu- 
 cation should embrace a general knowledge of all diseases to 
 which the human organism is liable, and their treatment. Spe- 
 cialism includes this knowledge, to which is added careful and 
 special study of the diseases and treatment that come within a 
 given department of practice. A dental education, therefore, is 
 a medical education, plus dental — or, special knowledge of the 
 diseases and treatment of the teeth and oral cavity. 
 
 I therefore advocate the teaching in our medical colleges of the 
 science of dental and oral surgery, not only that dental students 
 may gain a broader medical education, but that medical students 
 may be better informed regarding the diseases and treatment of 
 the teeth. The signature of the professor or professors of dental 
 and oral surgery should be considered as important upon the di- 
 ploma of graduation as the signatures of the teachers in any 
 other department. 
 
 At no previous time in the history of medicine in our country 
 has the necessity for a fuller course of medical instruction be- 
 come so apparent as the present ; and it will not be long before 
 a three-years course will be requisite to the respectable standing 
 of any medical college with the profession. In making this 
 change the fact should not be overlooked that their course can- 
 not be complete without the teaching of the diseases and treat- 
 ment of the teeth by properly educated and practical dental and 
 oral surgeons. 
 
 With this broader and better medical education on the part of 
 dental and oral surgeons, and a better knowledge of the nature 
 and influence of the diseases of the teeth and mouth, and their 
 proper treatment, on the part of medical men, there could be no 
 valid objection to the establishment of a section in dental and 
 oral surgery in the American Medical Association, upon an equal 
 footing with any other department of medical science. The import- 
 ance of this movement is being discussed among the most advanced
 
 12 
 
 dental practitioners and the most comprehensive medical teach- 
 ers. Sooner or later, this fuller and better education and condi- 
 tion must come, and the action of our medical colleges will 
 largely determine whether its consummation will be hastened or 
 retarded ; but, though delayed, this ultimate result will obtain. 
 
 As America, less wedded to old ideas and practices than Eu- 
 rope, gave to practical dentistry its first great impulse, so, too, it 
 may not be impossible that in this great Northwest, where ad- 
 vanced ideas more rapidly take root and expand, and new needs 
 are more readily met, the first steps may be taken towards this 
 desired end. 
 
 Having detained you longer than is customary on such occa- 
 sions, with my thanks for your kind attention, and believing that 
 some such plan as I have suggested for dental and medical in- 
 struction would be beneficial to the public, as well as those en- 
 gaged in practice, I leave these thoughts for your consideration. 
 If, perchance, what I have said should receive a greater audience 
 than this presence, I ask for it considerate thought and a gener- 
 ous criticism.
 
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